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目的了解广州地区腹泻病人中艰难梭菌(CD)及其毒素基因的分布情况并进行相关分析。方法收集261例住院及门诊腹泻病人粪便标本并提取宏基因组DNA,用PCR方法检测CD的种特异性基因tpi和毒素基因,包括毒素A基因(tcdA)、毒素B基因(tcdB)及二元毒素基因,并对检测患者的临床资料与CD携带的关联性进行分析。结果 261例腹泻病人粪便标本中,tpi基因阳性的有14例(5.4%),毒素阳性的6例(2.3%),均为A、B毒素同时阳性,未发现产二元毒素菌株。在14例tpi阳性标本中,71.4%(10/14)为住院病人,28.6%(4/14)为门诊病人;57.1%(8/14)为大于60岁患者,35.7%(5/14)为儿童。基因序列分析发现tpi基因有2种基因型,tcdA有2个基因型,tcdB有4个基因型,未发现明显优势基因型。结论目前在广州,CD的感染为散发;不能忽视儿童及社区获得性CD相关性腹泻的监测。
Objective To understand the distribution of C. difficile (CD) and its toxin genes in patients with diarrhea in Guangzhou and to analyze them. Methods A total of 261 stool samples from inpatient and outpatient diarrhea patients were collected and the genomic DNA was extracted. The tpi and toxin genes, including tcdA, tcdB and tcdB, were detected by PCR. Genes, and analyze the correlation between the clinical data and the CD carrier. Results Among 261 diarrhea patients, 14 cases (5.4%) were positive for tpi gene and 6 cases (2.3%) were positive for tpi gene. All of them were positive for A and B toxins, and no binary toxin strains were found. Of the 14 tpi positive specimens, 71.4% (10/14) were inpatients, 28.6% (4/14) were outpatients, 57.1% (8/14) were older than 60 years and 35.7% (5/14) For children. There were 2 genotypes of tpi gene, 2 genotypes of tcdA, 4 genotypes of tcdB and no obvious predominant genotypes. Conclusions Currently in Guangzhou, the CD’s infection is extinction; children and community-acquired CD-associated diarrhea can not be ignored.